Information About

Alumni Interview

George Richerson, M.D., Ph.D.

MD, 87PhD

What is your hometown?

Iowa City

How/when did you become interested in
science and medicine?

I was exposed to science from an early age, because my
father was on the faculty at the U of I College of
Medicine. He was a skilled clinician devoted to his
patients and was also a medical scientist that made many
significant contributions to the field of immunology. He
inspired me to try to understand the world around me, and
to try to help people by using logical thought and
quantitative reasoning to address their problems. This
initially led me to major in Aerospace Engineering as an
undergraduate at Iowa State University (but I remained a
Hawkeye fan in enemy territory). During this time I
received intense training in physics, mathematics and
computer science, and became very interested in space
science and aeronautics.

What interested you to pursue a
career in medicine and medical education?

During two summers in college, I worked for NASA at
Langley Air Force Base. While there I met several
astronauts that had both MD and PhD degrees, and I
learned that obtaining specialized scientific training
was a career pathway that might allow me to fly on the
space shuttle. I was also advised that my training in the
physical sciences would be valuable for solving problems
in medical science. This led me to apply to MD/PhD
programs, although I ultimately decided against becoming
an astronaut (at least not yet). Earlier in my life I had
vowed to my father that I wouldn’t follow in his
footsteps, so he probably thought this circuitous route
to a career in medicine was pretty funny.

What interested you to specialize in
neurology?

The brain is the most interesting organ in the body. I
was attracted to the challenge of understanding how it
works and curing diseases that affect it. Patients
with disorders of the nervous system often present with
unusual symptoms and signs and can be challenging and fun
to diagnose. There are already treatments for many of
these patients. Recent progress in developing treatments
for others has been astounding, and is continuing at a
pace much faster than most fields in medicine. It is
exciting to be part of that progress and to try to
contribute to it. It is also gratifying to be able to
treat patients with neurological diseases that other
physicians either do not recognize or don’t
understand well enough to know how to manage. I was
initially attracted to neurology because of my research
interests, but quickly found that the clinical practice
of neurology is fun, challenging and rewarding.

My laboratory uses patch clamp electrophysiology,
immunohistochemistry and molecular biology to understand
how the brainstem regulates blood pH and CO2. We
discovered that neurons that produce the chemical
serotonin are sensors of pH and CO2. When breathing is
impaired, the blood level of CO2 increases and pH
decreases. This causes serotonin neurons to become more
electrically active. We now believe that these
serotonin neurons play a critical role in many responses
needed to maintain a normal CO2 level. For example, they
cause an increase in breathing. They also cause arousal
if a person is asleep and their face gets covered by a
pillow, preventing airway obstruction by allowing the
head to be turned. We have recently confirmed that this
is the case in transgenic mice in which a development
defect in generation of serotonin neurons leads to a
severe defect in the response to CO2.

Although we began by studying a basic physiological
process, our basic science work has become very
clinically relevant. It has recently been found that
infants that died of sudden infant death syndrome (SIDS)
have a specific defect in serotonin neurons. SIDS claims
6 infant lives every day in the U.S. alone, and has long
been thought to be a defect in the response to airway
obstruction during sleep. We believe that death during
sleep is precisely what would occur when there is a
defect in CO2 sensation by serotonin neurons, and this
may be more likely to occur in an infant since they are
still developing.

My laboratory is also interested in the role of GABA
transporters in epilepsy. We have shown that these
transporters can be induced to reverse by some
anticonvulsant drugs, causing inhibition by nonvesicular
GABA release.

Another accomplishment I am proud of is that as
Program Director of the Yale Neurology Residency and the
head of a lab I have mentored many students and
physicians. This has been a gratifying part of my
career.

Is there a teacher, mentor or UI
Carver College of Medicine faculty member who has helped
shape your education?

Other than my father, my most important mentor was my
PhD advisor Peter Getting, PhD. He was also trained as an
engineer and then become interested in neuroscience, so
we shared many interests. He was a great teacher and role
model, and gave me the tools to be an independent
scientist. He was Professor of Physiology, and founded
the Neuroscience Program at Iowa. Sadly he passed away
this year after a long illness due to a stroke at a young
age.

I was also greatly influenced by Michael
O’Donovan, PhD, who provided a lot of practical
advice during my many struggles to get experiments to
work, as well as Robert Fellows, MD, PhD, who founded and
led the MD/PhD program at Iowa, and provided me with sage
career guidance.

How or why did you choose the UI for
your education and medical training?

I was attracted to the University of Iowa because of
the strength of the scientific community, including the
people mentioned above. It is very important to get
advice from those who are successful, and who understand
what needs to be done to obtain success yourself. The
presence of an NIH funded MD/PhD program was also a
strong indication that there would be support for the
kind of career I was interested in pursuing.

What kind of professional
opportunities or advantages has your UI medical training
provided?

Although I was drawn to Iowa by its science, the
medical training made me as well prepared to be a
physician as graduates of any other medical school, and
better than most. The long hours and hard work I went
through in those days gave me clinical skills that formed
a solid foundation for my later residency training. The
strengths of clinical training and science are widely
recognized throughout the country by professors at other
medical schools.

Please describe your professional
interests.

In addition to running a basic laboratory research, I
attend on the neurology wards for 1-2 months per year and
in a general neurology clinic for ½ day per week.
I also run the Yale Neurology Residency Program, teach
physiology to first year medical students, and give
lectures to other students and physicians.

What are some of your outside
interests?

I have a great family. My wife Mary has always been
very tolerant of my obsession with my work, but keeps me
sane by pulling me away from it when she can. My daughter
Diana is 18 and is a freshman in college majoring in
molecular biology. My son Matt is 17, and is planning to
go into engineering. Interesting career choices. They try
to go with me on business trips as much as they can, so
they have seen a lot of the world. As a result they seem
to understand global issues better than most people their
age.

I have always enjoyed athletics. I try to run as much
as I can, and ski, golf, and play racquetball as much as
I can get away with. I also love to travel, which is
convenient because my job requires that I travel a lot. I
am much more likely to accept a speaking engagement when
it is in an exotic locale (or if it includes the
opportunity to golf or ski on the side).

I have recently become addicted to rocks. It started
with small projects, but then grew to a large cobblestone
pathway, and culminated in a dry construction stone wall
made out of 60 tons of Connecticut field stone that
emulates many of the walls found in New England that
still stand after 200 years. I was in withdrawal this
year so am in the middle of a flagstone pathway. I figure
it is a better addiction than most.

Do you have an insight or philosophy
that guides you in your professional work?

I try to keep a very a positive attitude. There are
many times that a career in medicine or science can be
very difficult. If you can make it through these times
without collapsing, then the hard work is usually
rewarded. Finally, it is really important to surround
yourself with smart, outwardly-looking, motivated
people. They bring out the best in you.

What is the biggest change you've
experienced in medicine since you were a student?

There has become a lot more oversight by regulatory
agencies than there used to be. This is understandable to
a point, but sometimes it gets excessive. On the positive
side, new technologies have greatly improved the
diagnosis and treatment of many diseases. These changes
are a direct benefit of past medical research.

What one piece of advice would you
give to today's medical students?

If you have a career that you enjoy, you are much more
likely to be valuable and successful. If you choose a
field because it is lucrative, or because others tell you
that it is the hot field, you may find that you
don’t enjoy going to work.

What do you see as "the future" of
medicine?

There are still many diseases that can only be treated
with symptomatic therapies, rather than being cured.
Molecular and cellular biology and biochemistry, although
often viewed as esoteric and boring by medical students
and practicing physicians, are the key to cures for
devastating diseases like cancer, heart disease,
Alzheimer’s disease, ALS, and many, many
others. Those who recognize that these fields are
where the advances will come from are going to be the
ones that make them happen.

What do you see as “the
future” of your research in neurology?

My group is now working with a team of scientists
divided among 5 institutions to find a cure for SIDS. Our
team includes a neuropathologist who studies brains of
SIDS infants, pediatricians that perform physiological
tests on living newborn infants, a molecular geneticist
that designs transgenic mice, and neuroscientists
including myself that study these mice. Our dream is to
find a simple, cheap and noninvasive test (like the PKU
test) that could be given to every infant in the first
weeks of like. This test would identify those infants at
highest risk of SIDS, and they could then be treated to
prevent death.

I believe that my work on the basic biology of
serotonin neurons will also become more obviously
relevant to several other neuropsychiatric diseases in
which serotonin is central, like migraines, panic
disorder, sleep apnea and epilepsy. We are
currently working to establish these links.